Choroid constitutes the majority of the uvea with approximately 90% of total ocular blood flow. It supplies oxygen and nutrients to outer layers of the retina, facilitating the elimination of waste products. Additionally, choroid plays a crucial role in regulating intraocular pressure and temperature. The role of the choroid in the onset and progression of myopia has garnered attention, and evidence continues to accumulate with the development and evolution of optical coherence tomography (OCT).

Human choroid is highly sensitive to visual cues, dynamically altering its thickness bidirectionally. It plays a significant role in local growth of the eye. In myopia control therapies, significant choroidal thickening has been observed in response to interventions such as outdoor activities, orthokeratology, atropine eye drops, multifocal contact lenses, specially designed spectacles, and red light therapy. This suggests that choroidal thickness could serve as a potential biomarker for predicting future therapeutic effects.

In recent years, artificial intelligence has experienced a third boom and has become a familiar part of our daily lives in various fields. Even in the medical world, various studies are being conducted with the expectation that artificial intelligence can be a daily clinical aid. In the field of ophthalmology, research is also being conducted using various types of images. This paper describes Japanese research using an ultra-widefield scanning laser ophthalmoscope and optical coherence tomography.

Digital transformation (DX) has been used frequently in recent years, and has become an issue not only in business but also in the medical field. The Japanese Ophthalmological Society was one of the first to establish the Japanese Society of Artificial Intelligence (AI) in Ophthalmology and developed a database and AI for assessing corneal diseases. Most AI in ophthalmology focus on the anterior segment and retina, although AI is also used to measure eye movements. In this review, I describe our studies on eye trackers and AI, with examples of our experiments.